Download Adult congenital heart service - patent foramen ovale (PFO) patient

Patient information factsheet
Adult congenital heart service
Patent foramen ovale (PFO)
A PFO is a normal, flap-valve opening in the heart. It is situated in the wall (atrial septum) of the
heart that separates the right atrium from the left atrium (the top two heart chambers) while in
the womb but usually closes spontaneously following birth.
In a quarter of people it stays open and can intermittently allow blood flow to pass from the
right atrium to the left atrium. This abnormal flow has been associated with stroke, complex
migraine, decompression illness and, rarely, positional breathlessness.
Closing the PFO
A PFO measuring less than 40mm can usually be closed using a double-disc device that is shaped
like a double-sided umbrella. The procedure is carried out under general anaesthetic in the
catheterisation laboratory under ultrasound guidance with x-ray screening.
The device is passed through a long tube (catheter) from the femoral vein at the top of the leg,
into the heart. The device is then positioned across the flap valve in the heart. Eventually the
heart tissue will grow over the device and it will become part of the heart wall. Patients cannot
feel the device when it is in place.
On admission to the ward
To have the PFO closed you will usually need to stay in hospital for one or two nights, probably
one before and one after your procedure. Sometimes patients are admitted the same day as
their procedure.
When you arrive on the ward you will be admitted by the nursing staff who will check your
blood pressure, pulse, temperature and show you around the ward area. A doctor will then
examine you, explain the procedure’s benefits and potential risks and ask you to sign a consent
form.
You will have:
• a blood test
• an ECG (electrocardiogram - tracing of the heart’s electrical activity)
• a chest X-ray
You may also have an ECHO (echocardiogram), which is an ultrasound scan of your heart.
You will meet an anaesthetist as you will need to have a general anaesthetic for your procedure.
You will not be able to eat or drink for about six hours before the procedure.
Possible complications
We have over 18 years of experience performing these procedures and we consider it to be safe
and low-risk. Significant complication risks are under 1%. Bleeding, bruising, palpitations and a
sore throat are more common however. The medical team will discuss any possible complications
with you when you sign your consent form.
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Patient information factsheet
After the procedure
After the procedure the ward nurses will continue to monitor you and check the small wound at
the top of your leg (groin), as there is a small risk of bleeding or swelling.
You may feel sleepy when you return to the ward as a result of the anaesthetic. As you are
awake enough, the nurses will get you something to eat and drink. You will normally be given
sips of water.
After a few hours of bed rest you will be able to get up and move around the ward. You may
have some bruising and discomfort in your groin.
On the day following your procedure you will have another ECG, chest X-ray and ECHO to
confirm that the device is well-positioned. The medical team will discuss the results and any
follow up plans with you before you are allowed to go home. They may also prescribe tablets for
you to take home.
Before you go home the nurses will remove the groin dressing, check your wound and explain
how to care for it.
Going home
Do not drive or return to work for at least 48 hours after the procedure.
An outpatient appointment will be sent to you through the post for approximately six to twelve
weeks after the procedure to assess your device and review your medications.
Further information
If you have any concerns or questions once you are home, please feel free to contact the
following for advice:
Adult congenital nurse specialist: 023 8120 4739
Hospital switchboard: 023 8077 7222 then ask for bleep 1481
Cardiac short stay unit: 023 8120 4420
Ward E3: 023 8120 6472
Ward E4: 023 8120 6473
If you need a translation of this document, an interpreter or a
version in large print, Braille or on audio tape, please telephone
023 8120 4688 for help.
Version 1. Published September 2013. Due for review September 2016. PFO001.01
www.uhs.nhs.uk